A 53-year-old male presents to your office for a regularly scheduled check-up. The patient was diagnosed with type II diabetes mellitus two years ago. To date, diet, exercise, and metformin have failed to control his elevated blood glucose. Past medical history is also significant for hypertension. The patient does not smoke or use cigarettes. Laboratory values show a hemoglobin A1c (HbA1c) of 8.5%. You decide to add sitagliptin to the patient’s medication regimen. Which of the following is the direct mechanism of action of sitagliptin?
AIncreases secretion of insulin in response to oral glucose loads and delays gastric emptying
BInhibits degradation of endogenous incretins
CActivates transcription of PPARs to increase peripheral sensitivity to insulin
DDepolarizes potassium channels in pancreatic beta cells
EInhibits alpha-glucosidases at the intestinal brush border
A 57-year-old woman presents to the emergency department with acute onset confusion, sweating, weakness, and tremors. She says that the symptoms started when she went to dinner with friends and had several drinks of alcohol without eating much food. Her past medical history is significant for type 2 diabetes, and she was recently started on a new medication for this disease. She mentions that her doctor warned her about the risk of low blood sugar, especially if she drinks alcohol or skips meals. Which of the following describes the mechanism of action for the most likely diabetes drug that this patient started taking?
AInhibiting dipeptidyl peptidase
BClosing potassium channels
CInhibiting alpha-glucosidase
DDecreasing hepatic gluconeogenesis
EBinding to peroxisome proliferator-activating receptors
A 55-year-old male is hospitalized for acute heart failure. The patient has a 20-year history of alcoholism and was diagnosed with diabetes mellitus type 2 (DM2) 5 years ago. Physical examination reveals ascites and engorged paraumbilical veins as well as 3+ pitting edema around both ankles. Liver function tests show elevations in gamma glutamyl transferase and aspartate transaminase (AST). Of the following medication, which most likely contributed to this patient's presentation?
AGlargine
BPramlintide
CPioglitazone
DGlipizide
EMetformin
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